Definition of "Hematuria"

Last modified: 4 days



Hematuria is presence of RBC in urine. Hemoglobinuria is specifically Hg in urine.

Patient information

What is hematuria?
It's where we find blood in urine. Specifically, red blood cells.

Wait, what different sorts of blood cells are there?
There's red ones, white ones, and platelets. Reds help to carry oxygen, hence it's red color because of the iron that helps bind with oxygen. Whites are cells of the defense system. Platelets help to stop bleeding, by clumping together and making a clot.

Cause
  • UTI w/ bacteria, usually E coli, followed by Klebsiella pneumonia and Staphylococcus → WBC also present
  • Stones in the kidney, bladder or ureter (nephrolithiasis)
  • Tumor in the urinary tract (kidneys, ureters, urinary bladder, prostate, urethra)
  • Polycystic kidney disease
  • Trauma
  • Cancer of the kidney, prostate, or bladder
  • Benign prostatic hyperplasia → older men (>50yo)
  • Vigorous exercise (high intensity exercise)
  • Idiopathic (unknown)
  • Less commonly:
    • Glomerular bleeding, e.g. IgA nephropathy, Alport syndrome, thin basement membrane disease
    • Sickle cell disease
    • Schistosomniasis, caused by schistosoma h, a major cause of hematuria in African countries
    • Recent instrumentation of the urinary tract
    • Prostatitis
    • Urethritis
    • Kidney diseases
  • Rarely:
    • Loin pain hematuria syndrome, if combined w/ flank pain
    • Paroxysmal noctural hemoglobinuria, where Hb of hemolyzed cells is passed into the urine, rare
    • AV malformation of the kidney, rare
    • Fibrinoid necrosis of the glomeruli, due to malignant HTN
    • Allergy, can cause episodic gross hematuria, in kids
    • Left renal vein HTN (aka nutcracker phenomenon), a vascular abnormality, responsible for gross hematuria, rare
    • Ureteral pelvic junction obstruction, condition beginning from birth, where the ureter is blocked between the kidney and bladder, rare
    • March hematuria, secondary to repetitive impacts on the body, usually the feet
    • Athletic nephritis, secondary to strenuous exercise
    • Alport syndrome

Patient information

What causes oxygen carrying red blood cells, to be found in urine?
So any sort of damage to the kidneys, as they're meant to let certain things go, but not blood cells. Blood cells are supposed to be bigger than the size of the pores in the kidney's glomerulus (8nm), because platelets are 2-3µm, reds are 6-8µm, and whites are 7-30µm, depending on which one we're talking about. So, we find red blood in urine, when there's damage to the kidney. So it's everything from UTI's, stones, cancer, and trauma.

Dx
  • Medical Hx
  • Urinalysis (urine testing), which may need to be repeated
  • Imaging:
    • CT scanning or U/S, to confirm kidney stones
    • Cystoscopy of the ureter and bladder, and CT urography, for risk of cancer of the bladder, prostate, ureters, or kidney, including
DDx
  • Drugs, can cause red discloration of the urine, including:
    • Sulfonamides
    • Quinine
    • Rifampin
    • Phenytoin
  • Consumption of beets (beeturia)
  • Menstruation
Tx
  • Abx, for an UTI
Epidemiology
  • Risk of malignancy is very low, in young Pt's
See also

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Definition of Hematuria | Autoprac


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